Acquired Drug Resistance during Standardized Treatment with First-line Drugs in Patients with Multidrug-Resistant Tuberculosis.
10.4046/trd.2009.66.3.198
- Author:
Doosoo JEON
1
;
Dohyung KIM
;
Hyungseok KANG
;
Jinhong MIN
;
Nackmoon SUNG
;
Soohee HWANG
;
Seungkew PARK
Author Information
1. National Masan Tuberculosis Hospital, Masan, Korea. sooli10kr@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Tuberculosis;
Multidrug resistance;
Drug resistance
- MeSH:
Drug Resistance;
Drug Resistance, Multiple;
Ethambutol;
Hospitals, Chronic Disease;
Humans;
Isoniazid;
Korea;
Medical Records;
Nitroimidazoles;
Pyrazinamide;
Retrospective Studies;
Rifampin;
Risk Factors;
Sulfonamides;
Tuberculosis;
Tuberculosis, Multidrug-Resistant
- From:Tuberculosis and Respiratory Diseases
2009;66(3):198-204
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: First-line drugs, if sensitive, are the most potent drugs in the treatment of multidrug-resistant tuberculosis (MDR-TB). This study examined the frequency and risk factors associated with acquired drug resistance to first-line drugs during a standardized treatment using first-line drugs in patients with MDR-TB. METHODS: This study included patients who were diagnosed with MDR-TB at the National Masan Tuberculosis Hospital between January 2004 and May 2008, treated with standardized first-line drugs, and for whom the preand post-treatment results of the drug susceptibility test were available. Their medical records were reviewed retrospectively. RESULTS: Of 41 MDR-TB patients, 14 (34.1%) acquired additional resistance to ethambutol (EMB) or pyrazinamide (PZA). Of 11 patients initially resistant to isoniazid (INH) and rifampicin (RFP), 3 (27.3%) acquired additional resistance to both EMB and PZA, and 3 (27.3%) to PZA. Of 18 patients initially resistant to INH, RFP and EMB, 6 (33.3%) acquired additional resistance to PZA. Of 6 patients initially resistant to INH, RFP and PZA, 2 (33.3%) acquired additional resistance to EMB. Ten of the 41 MDR-TB patients (24.4%) changed from resistant to susceptible. No statistically significant risk factors associated with acquired resistance could be found. CONCLUSION: First-line drugs should be used cautiously in the treatment of MDR-TB in Korea considering the potential acquisition of drug resistance.
